Diabetes Education Is 'Fundamental'

Three new studies show that teaching people about their diabetes and giving them strategies to manage it can help them lower their blood sugar levels.

Each study examined different approaches to diabetes education and how they affected blood sugar control, the centerpiece to good diabetes management.

"Diabetes education is fundamental," says Joel Zonszein, M.D., at Montefiore Medical Center in New York City. "And, the time and effort spent with patients relates nicely to better outcomes. In these studies, the strategy is a little bit different in each, but it shows that education works."

Behavior change

Researchers set out to encourage study participants to change their behavior - to stop thinking of their blood sugar levels as either "bad" or "good." Instead, they asked them to identify factors that may have contributed to that number, and seek strategies to change it and keep it from happening again.

Long-term blood sugar control is measured by averaging a person's blood sugar levels over two to three months' time. This results in a number known as HbA1C, or A1C. In general, people with diabetes are encouraged to keep their A1C levels below 7 percent.

"We don't allow labeling," says Katie Weinger, Ph.D., at the Joslin Diabetes Center in Boston. "Those numbers are information, and all information is valuable."

Those in the individual education programs were able to bring their A1C below 7 percent more than 20 percent of the time, compared with nearly 14 percent for those in the group education programs, and about 13 percent for those who did not attend any educational programs.

Better control

Dr. Weinger compared the A1C levels in her behavior change group with those who participated in standard group or individual diabetes education programs. At the start of the study, the average hemoglobin A1C was 9 percent. People in the structured behavioral group reduced their A1C by almost 1 percent, while those in standard group and individualized education programs dropped their A1C by about 0.5 percent.

In the second study, researchers compared the success rates of more than 600 people in two states who received diabetes education as a group, as an individual, or not at all. At the start of the study, the average A1C was above 7 percent.

Different focus

The third study focused mostly on low-income black and Latino patients who had trouble controlling their diabetes. The average A1C at the start of the study was a little over 9 percent.

Participants either watched a video on diabetes management and received coaching sessions via telephone, or were given an educational brochure. A1C levels dropped about by about 0.5 percent in both groups.

"For people who are struggling with self-management, help is available from your medical team," says Dr. Weinger. "There are people trained and able to support and help you. Diabetes is difficult to manage alone."

The results of the studies were published in the Archives of Internal Medicine.

Always talk with your health care provider to find out more information.